Prescription costs for retirees, pensioners and S1 holders

Terms used

• S1 — The S1 is a form from the foreign authority that pays your pension, giving you healthcare in Spain at that country's expense.
• INSS — The INSS is Spain's national social security institute, where you register your S1.
• CAISS — The CAISS is an INSS office where you register your S1 and deal with social security matters.
• Tarjeta sanitaria — The tarjeta sanitaria is your regional health card, which shows your coverage and your pensioner code.

Key rules

• Pensioner rate: Pensioners pay 10% of the price of financed medicines, with a monthly cap that depends on income.
• S1 holders: An S1 registered in Spain puts you on the pensioner rate once your health card shows the right code.
• Foreign pension only: A foreign pension without an S1 does not automatically qualify you for the pensioner rate.
• Refunds: The pharmacy does not stop charging at the cap; your region refunds the excess later.

What you pay as a pensioner

Pensioners pay 10% of the price of medicines covered by the public health system. Your monthly total is capped, and the cap depends on your income. The calculator below can estimate your monthly cost.

Monthly caps by income

These are the caps for pensioners, by yearly income:

• Under 18,000 euros: about 8.14 euros a month.
• From 18,000 euros to under 100,000 euros: about 18.32 euros a month.
• 100,000 euros or more: about 61.75 euros a month.

The government updates these amounts from time to time. Check the current figure for your band with your regional health service.

Does an S1 give you the pensioner rate?

Yes, in practice. If your S1 is registered in Spain, you are treated as a pensioner at the pharmacy. You pay 10% and the monthly cap applies. Regional health services apply this once the S1 is registered, and some regions handle it differently, so confirm at your health centre.

To get there, do this in order:

1. Register your S1 at an INSS office (CAISS). This gives you the right to healthcare.
2. Register with your regional health service to get your health card (tarjeta sanitaria).
3. Check that the card shows the pensioner code. Bring your S1 and proof of your foreign pension in case the health centre asks for them.

The documents and checklist below cover these steps.

A foreign pension without an S1

A foreign pension on its own does not automatically give you the pensioner rate. The rate is aimed at people who receive a Spanish public pension and are registered as pensioners. Without an S1, your health service looks at the status on your health card, and regions differ. Ask your health centre whether your situation qualifies in your region.

The cap is not applied at the pharmacy

The pharmacy charges the normal 10%, even after you pass your cap. The regional health service refunds the excess later, usually by bank transfer. Timing and procedure vary by region. Keep your receipts, and see the refund steps below.

Claiming back copayments above the monthly cap

Getting back copayments above your monthly cap

• Pay the normal 10% at the pharmacy and keep your receipts: every time you collect a prescription

• Make sure your health card (tarjeta sanitaria) and your bank account are registered with your regional health service: before the end of the first month you use the cap

• Wait for the refund: in most regions the health service works out the excess from your electronic prescription records and pays it into your bank account without an application: usually quarterly, or at other regular intervals set by your region

• If no refund arrives, ask your regional health service whether you must file a claim, and send your ID, health card, bank details and pharmacy receipts: if the usual payment date passes without a transfer

• Check your own region's schedule and portal, because each region runs its own refund and some ask for registered bank details or a claim form: when you first register for the public health service

Documents you need

• Your S1 form, issued by the foreign authority that pays your pension, registered at an INSS office (CAISS, the Spanish social security office).

• Your health card (tarjeta sanitaria) from your regional health service, showing the pensioner code.

• Proof of your foreign pension, in case your health centre asks for it.

Requirements vary by region, so confirm with your local health centre which papers it wants.

Checklist

• Register your S1 form at an INSS office (CAISS) to get the right to healthcare.

• Find your income band and the matching monthly cap with your regional health service.

• Ask your regional health service how and when it refunds amounts above the cap.

Estimate your monthly prescription cost

Work it out

What you enter

• Total pharmacy price of your financed medicines this month (EUR): The pharmacy receipt, adding up the price of each financed medicine.
• Your monthly cap for your income band (EUR): Use 8.14 if you earn under 18,000 euros a year, 18.32 from 18,000 to under 100,000 euros, or 61.75 at 100,000 euros or more.

Figures used

• Pensioner share of the pharmacy price: 10 % (as of 2025)

Worked example (with Total pharmacy price of your financed medicines this month 120 EUR, Your monthly cap for your income band 8.14 EUR)

When the sum misleads

• Enter only medicines financed by the public system. A medicine that is not financed is paid in full and does not count towards the cap.
• If a medicine costs more than its reference price, you also pay the difference. Add it to the result.
• If you receive a non-contributory pension, social integration income or are in another exempt group, you pay nothing.
• The pharmacy charges the full 10%. Any amount above the cap comes back later from your region.

Frequently asked questions

Does a foreign pension alone give me the pensioner rate?

No, a foreign pension on its own does not automatically give you the pensioner rate. The rate is for people who get a Spanish Social Security pension or an equivalent Spanish public pension and are registered as pensioners. If you get Spanish healthcare through an S1, ask your regional health service how it shows your status.

Do I pay the pensioner rate if I hold an S1?

Yes, S1 holders registered in Spain are treated as pensioners at the pharmacy, with the 10% rate and the monthly cap. Regional health services apply this once your S1 is registered, so make sure the registration is complete.

Will the pharmacy stop charging me once I reach the monthly cap?

No, the pharmacy does not apply the cap for you. It charges the normal rate, and your regional health service refunds the excess later, usually by bank transfer. Some regions have automatic or digital systems.